Intensive care unit versus floor admission following lower extremity free flap surgery: Is there a difference in outcomes?. (Record no. 403)

MARC details
000 -LEADER
fixed length control field 03562nam a22004097a 4500
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fixed length control field 220926s20222022 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 0738-1085
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1002/micr.30935 [doi]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 35792568
245 ## - TITLE STATEMENT
Title Intensive care unit versus floor admission following lower extremity free flap surgery: Is there a difference in outcomes?.
251 ## - Source
Source Microsurgery. 2022 Jul 06
252 ## - Abbreviated Source
Abbreviated source Microsurgery. 2022 Jul 06
253 ## - Journal Name
Journal name Microsurgery
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2022
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Manufacturer FY2023
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Publication date 2022 Jul 06
265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE]
Publication status aheadofprint
266 ## - Date added to catalog
Date added to catalog 2022-09-26
501 ## - WITH NOTE
Local holdings Available online from MWHC library: 1996 - 2002
520 ## - SUMMARY, ETC.
Abstract BACKGROUND: Free tissue transfer (FTT) lower limb salvage requires costly multidisciplinary care. Traditionally, patients who undergo FTT reconstruction for lower extremity (LE) wounds were admitted to the intensive care unit (ICU) in the immediate postoperative period for close monitoring. During the COVID-19 pandemic, our practice shifted toward admitting FTT patients to the floor postoperatively instead of the ICU. The purpose of this study is to compare surgical outcomes in patients admitted to the floor versus ICU immediately following LE free flap reconstruction.
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Abstract CONCLUSION: Our findings suggest that postoperative floor admission does not decrease flap success rates and should be considered in patients who undergo FTT to LE reconstruction and are otherwise stable. In the ongoing era of health care cost containment, microsurgery centers should consider appropriate floor training to allow medically stable free flap patients to avoid an ICU stay. Copyright © 2022 Wiley Periodicals LLC.
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Abstract METHODS: We retrospectively reviewed patients undergoing LE FTT reconstruction from 2011 to 2021. Flap monitoring consisted of an implantable Cook-Swartz Doppler probe for muscle flaps and ViOptix tissue oximetry for fasciocutaneous flaps; clinical exam and hand-held dopplers were not the primary flap monitoring techniques. Patients were divided into two groups depending on whether they went to the ICU or floor postoperatively. To ensure proper comparability between cohorts, we corrected for age, BMI and Charlson Comorbidity Index (CCI) using 1:2 propensity score matching (floor: ICU). Primary outcomes included early postoperative complications, flap takeback and salvage, flap success, and postoperative length of stay (LOS).
520 ## - SUMMARY, ETC.
Abstract RESULTS: A total of 252 patients were identified. Forty-five patients (17.9%) were admitted to the floor postoperatively and 207 patients (82.1%) to the ICU. Overall, microsurgical success rate was 97.2%, which was similar for floor and ICU patients. Flap takeback and salvage were similar between cohorts. Average postoperative LOS was significantly shorter in floor patients (15.7 vs. 19.1 days, p = 0.043).
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element IN PROCESS -- NOT YET INDEXED
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Institution MedStar Georgetown University Hospital/MedStar Washington Hospital Center
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Institution MedStar Washington Hospital Center
656 ## - INDEX TERM--OCCUPATION
Department MedStar General Surgery Residency
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Department Surgery/Plastic Surgery
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Medline publication type Journal Article
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Local Authors Deldar, Romina
Institution Code MGUH
Program MedStar General Surgery Residency
Degree MD
Resident year Resident PGY 4
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Local Authors Fan, Kenneth L
790 ## - Authors
All authors Abu El Hawa AA, Bovill JD, Deldar R, Evans KK, Fan KL, Gupta N, Truong BN
856 ## - ELECTRONIC LOCATION AND ACCESS
DOI <a href="https://dx.doi.org/10.1002/micr.30935">https://dx.doi.org/10.1002/micr.30935</a>
Public note https://dx.doi.org/10.1002/micr.30935
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 09/26/2022   35792568 35792568 09/26/2022 09/26/2022 Journal Article

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